Diabetes mellitus is an alarming medical problem affecting more than 194 million people. Persisting diabetic conditions often lead to damage of blood vessels, increased risk of coronary artery disease, myocardial infarction, atherosclerosis, claudication and stroke, blindness, nerve damage and in extreme situations may event lead to amputations. The principal cause of these complications is hyperglycemia mainly due to lack of insulin, or insulin resistance, or defects in insulin signaling pathways.
Management of diabetes focuses mainly on several approaches intended to sustain reduction in hyperglycemia that reduces the risk of developing microvascular and macrovascular complications. In addition to insulin, control of hyperglycemia mainly involves use of biguanides, sulfonylureas, D-phenylalanine derivatives, meglitinides, peroxisome proliferator-activated receptor-γ (PPAR-γ) agonists (thiazolidine diones) and α-glucosidase inhibitors. These drugs augment insulin secretion from pancreatic islets, act to reduce hepatic glucose production, interfere with gut glucose absorption or enhance insulin action, suppress glucose production and augments glucose utilization. The efficacies of these compounds are still under debate due to either side effects or many patients who respond initially become refractory to treatment over a period of time. Considering the multifactorial nature of diabetes that can not be ascribed to a single genetic or environmental change but arise from a combination of genetic, environmental or behavioral factors, alternative approaches are necessary for better management. Extracts of seeds and leaves of fenugreek have been historically known for their antihyperglycemic activity and non-toxicity. Though hypoglycemic effects of fenugreek have been attributed to several factors and mechanisms, its active principles have been only partially purified viz., trigonelline and 4-hydroxyisoleucine, which account for the antidiabetic activity in part. They are shown to be act by enhancing insulin secretion from islets of Langerhans. So far no attempts have been made to explore the possibility of insulin mimicking effect of fenugreek seeds extract at cellular and molecular level.
Fenugreek and other traditional plants are currently being investigated for their potential as a source of new hypoglycaemic compounds for the treatment of diabetes. However, with the exception of guanidine, many of the hypoglycaemic compounds isolated from plants are small molecules such as alkaloids, flavanoids, glycosides, steroids, aminoacids or minerals that are not suitable for pharmaceutical drug development. However, medicinal plant extracts used for treating hyperglycemia might contain number of components that together contribute to over-all effectiveness. Therefore isolating individual component from such extracts may not be as effective.